TN 38 (04-12)

A. Introduction to statement(s) or opinions of claimant(s) or other person(s)

In recording information for the file, it is important that we distinguish facts from opinions because we might rely upon a statement of fact without question while a statement of opinion is by nature more open to inquiry.

B. Definitions of statement of fact and opinion

1. Statement of fact

A statement of fact is a statement made concerning a matter, which is susceptible to exact knowledge, by one having personal knowledge of the matter.

2. Opinion

An opinion is a belief arrived at because of an inference on the part of the person forming the opinion.

3. Example

If a witness states that the claimant and number holder (NH) were ceremonially married, it is a statement of fact if he or she was present at the ceremony. It is an opinion if he or she was not present but bases his or her statement on the couples having referred to each other as husband and wife.

C. Procedure for evaluating statements

Consider the following criteria when evaluating statements made by claimants or others:

• Is the statement free of inconsistencies? Is the statement clear and precise?

• Does someone who has a personal interest in the outcome make the statement? (If so, we should consider this in determining how much weight to give the statement.)

• Is there any indication of bias for or against the claimant?

• Is the statement one that denies knowledge of a fact although the statement-maker was clearly in a position to know the facts?

• Is the statement one that contains elements, which we can independently corroborate by other evidence?

• Is the statement one containing information against the statement-maker's own best interests or is it self-serving?

• When did the claimant or other person make the statement? Is the claimant’s or other person’s statement based on memory of something that occurred recently or long ago?

• Is the claimant’s or other person’s statement based upon first-hand knowledge, rather than opinion, inferences, or hearsay?

D. Procedure for recording statements on the SSA-795 (Statement of Claimant or Other Person)

1. General information for recording statements on the SSA-795

Use an SSA-795 whenever a signed statement is required or desirable, except when we request some other form or questionnaire or we can readily adapt for the statement. Prepare an SSA-795 using the claimant's own words whenever possible.

2. Uses of the SSA-795

The following list represents some uses of the SSA-795:

• Statements on legal and equitable adoption;

• Statements about divorce and termination of a prior marriage of a claimant or NH;

• When there is a conflict in the evidence;

• Special situations where unusual development is found necessary by the field office (FO), foreign service post (FSP), or is requested by the payment center (PC);

• Developing wage discrepancy and coverage cases which involve specific problems; and

• Joint bank account rebuttal or designation of burial fund for Title XVI claims.

3. Mailing the SSA-795 to the claimant or other person

Take the following actions prior to mailing the SSA-795 for signature:

1. Enter the NH's name and social security number (SSN);

2. Complete the SSA-795 for the person making a statement, based on a telephone contact, unless the claimant or other person insists on completing the SSA-795;

3. Always advise the claimant or other person about the purpose of the requested statement; and

4. Provide clear instructions explaining how to complete the SSA-795.

E. Procedure for recording opinions

During the interview, a claimant or other person may express relevant opinion.

1. Signed statement obtained

1. If possible, include the opinion in the form of a statement signed by that person. Procedure for evaluating statements, see GN 00301.305C (in this section). The signed statement should include an explanation of the basis for the opinion.

2. Fax the SSA-795 into Electronic Disability Collect System (EDCS) or Non Disability Repository for Evidentiary Documents (NDRed) to retain signature in an electronic format. Do not retain paper document.

For more information on retention of paper material after faxing into either the eDIB folder or claims folder using NDRed, refer to POMS GN 00301.322.

2. Signed statement not obtained

1. Include the information on a report of contact (RC).

2. Take care to record, as accurately as possible, what the interviewed claimant or person said. For accuracy, we should quote the claimant or other person’s exact words on the RC.

F. Procedure when handling confidential reports

Occasionally an informant will provide information only in confidence; i.e., he or she does not want the claimant or beneficiary or other person with whom we might expect to discuss the information to know the source of our knowledge or possibly even the fact that we possess it. Inform the person making the request that we cannot promise that we will not disclose the information. For more information regarding confidentiality and disclosure, see GN 03301.025.

G. Procedure for completing other forms

Follow instructions in:

• DI 11005.023, Completing the Disability Report Adult Form SSA-3368.

• DI 11005.030, Completing the SSA-3820 (Disability Report - Child).

• DI 12095.030, SSA-3441-BK (Disability Report - Appeal).